Additional Effects of Joint Mobilization in Addition to Rocabado Exercises on Alleviating Trismus Following Third Molar Extraction

Without appropriate early intervention, prolonged trismus can lead to lasting complications like reduced jaw mobility or temporomandibular joint disorders.Therefore joint mobilization will impact on trismus, that will offer valuable insights into how these interventions will affect inflammation, muscle function and overall healing process within TMJ besides rocabado exercises that involves a series of movements and stretches targeting the muscles and joints involved in chewing,swallowing and speaking and minimizing muscle tension and opening the mouth, preventing further deterioration of jaw function and improving overall quality of life of individuals. If found effective, this will be added to the literature for the treatment of trismus after third molar extraction.

Study Overview

• Status: Active, not recruiting
• Conditions: Trismus
• Intervention / Treatment: Procedure: Electrotherapy; Procedure: Rocabado exercises; Procedure: Maitland oscillatory mobilizations

• Study Type: Interventional
• Enrollment (Estimated): 54
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Punjab
    • Rawalpindi, Punjab, Pakistan, 46000
      • Foundation University College of Physical Therapy

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Referral or consultation from a dentist to confirm the diagnosis of trismus.
• Age 18-45 years
• Both genders (Male and Female)
• Maximal interincisal opening ≤ 35mm (Restricted jaw motion).
• Unilateral/Bilateral impacted lower third molars.
• 3 days Post mandibular Third molar extraction

Exclusion Criteria:

• Local Infection or bleeding post third molar extraction.
• Patients with Acute pericoronitis
• Patient undergoing chemotherapy and radiotherapy.
• Type I diabetes, renal failure and chronic liver disease were excluded as immunocompromised state.
• Pregnant or lactating women.
• Cyst or tumor associated with impacted tooth

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Maitland joint mobilization + Rocabdo exercises; Therapeutic ultrasound: pulse mode - 1:4, frequency 3 MHz, intensity- 0.8 watt/cm2 for about 3-4 Minutes. Mobilizations will be performed in Grade 1 initially and then progressed to Grade 2 and 3. Techniques used are anterior, lateral and inferior glides Frequency: 3-4 times in 1 week . 4 sessions in total.	Procedure: Electrotherapy; Therapeutic ultrasound: pulse mode - 1:4, frequency 3 MHz, intensity- 0.8 watt/cm2 for about 3-4 minutes.; Procedure: Rocabado exercises; 6 Rocabado exercises 6 Reps each.; Procedure: Maitland oscillatory mobilizations; Mobilizations will be performed in Grade 1 initially and then progressed to Grade 2 and 3. Techniques used are anterior, lateral and inferior glides
Experimental: Rocabado exercises; Participants of this Group will receive the conventional physical therapy along with 6 Rocabado exercises.6 reps each Therapeutic ultrasound: pulse mode - 1:4, frequency 3 MHz, intensity- 0.8 watt/cm2 for about 3-4 Minutes. Frequency: 3-4 times in 1 week . 4 sessions in total.	Procedure: Electrotherapy; Therapeutic ultrasound: pulse mode - 1:4, frequency 3 MHz, intensity- 0.8 watt/cm2 for about 3-4 minutes.; Procedure: Rocabado exercises; 6 Rocabado exercises 6 Reps each.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain intensity	pain will be measured using Numeric pain rating scale	1 week
Range of motion	A Vernier caliper will be used to measure maximal incisal opening (MIO) ≤ 35 mm (ROM)	1 week
Functional Performance	Gothenburg Trismus Questionnaire will be used for assessing functional performance or trismus-related quality of life.	1 week

Collaborators and Investigators

• Sponsor: Foundation University Islamabad

Study record dates

Study Major Dates

• Study Start (Actual): June 10, 2024
• Primary Completion (Estimated): December 10, 2024
• Study Completion (Estimated): December 30, 2024

Study Registration Dates

• First Submitted: July 30, 2024
• First Submitted That Met QC Criteria: July 30, 2024
• First Posted (Actual): August 2, 2024

Study Record Updates

• Last Update Posted (Actual): August 2, 2024
• Last Update Submitted That Met QC Criteria: July 30, 2024
• Last Verified: July 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Nervous System Diseases; Neurologic Manifestations; Neuromuscular Manifestations; Spasm; Trismus
• Other Study ID Numbers: FUI/CTR/2024/18

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No